Do they, or don't do they - enterostomy and continence consultants self-assessing the integration of sexual health issues in diastase-management at the annual national meeting

Ucsnik, L1

1: Medical University Vienna

Introduction: Sexual function and anal/urinary incontinence are symptoms of troubled pelvic function. Incontinence results in reduced social life, isolation and, understandably, in reduced sexual activity. As a consequence quality of life is severely impaired. When these patients look for professional help, they are often unsuccessful, in particular when sexuality is concerned.

Objective: Sexual Health issues are not yet part of routine disease-management when dysfunction of the pelvic floor and incontinence are the essential topic of medical consultation. Therefore, highly specialized members of various medical professions (doctors, nurses and physiotherapists) were invited during a continence-meeting to take part in a survey self-evaluating the consideration of sexual aspects in the medical routine. The main purpose was to analyze to which degree sexuality is integrated in the context of continence at all.

Methods: At the meeting 190 questionnaires were distributed. 32 Questionnaires were returned and descriptively analyzed.

Results: Most of the participants were female, aged between 41-50 years. They worked in public hospitals or in other health care institutions (38% each). 22% had more than 21 years of clinical experience. Only 16% of the survey’s participants asked between 80 and 100% of their patients about their sexual life and possible disturbances, 22% of the doctors asked between 41 and 60% of the patients, 28% asked up to 20%. 47% of the doctors assumed that their patients had impaired sexuality but did not ask about it. 63% stated that they were asked by up to 20% of their patients about sexual problems. This implies that the vast majority of patients do not disclose their sexual impairment spontaneously. The participants confirmed that sexuality should be actively addressed in case of certain diagnoses (78%), in pain management (59%), during andro-/menopause (56%) and before surgery (53%). 78% did not answer whether they had undergone some sort of sexual medicine training, whereas 22% positively had an official qualification in sexual medicine. In case of troubled sexuality the next steps offered by the survey’s participants was: referring to other medical specialists (41%), explaining the physiology of sexual function (38%), sexual medicine treatment and sexual therapy (each 25%). 47% of the survey’s participants confirmed the necessity for sexual medicine qualification in order to successfully treat impaired sexual health.

Conclusions: The participants of this self-assessment-sex-med-survey were quite experienced in the field of incontinence. The results of this survey show that addressing impaired sexual health is not part of routine in their disease-management-programs. Only 22% had had sexual medicine training. In the field of incontinence (urine and/or feces) there is an increased demand to raise awareness in congresses, as well as to provide concepts for training skills and acquire appropriate knowledge in order to substantially improve the patients’ quality of life.